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Could It Be Autism?

Communication challenges often offer clues

Typically, babies babble and toddlers chatter. But a child with autism spectrum disorder may lack these — and other — communication skills.

Rachel Loftin, PhD, a clinical psychologist who specializes in autism spectrum disorder at Rush's Autism Assessment, Research, Treatment and Services (AARTS) Center describes some of the common communication and socialization problems that might signal autism:

Early language delays

By the time children are 18 months old, they are often saying a handful of words. “In contrast, a child with autism may not say anything or may only repeat a couple of words,” Loftin says.

You can have language and communication delays and not have autism. But kids who have communication delays without autism develop other strategies to try to communicate their needs, such as eye contact or gestures.

For kids with autism, those attempts to compensate are usually not there.

Limited gestures

Children with autism are less likely to gesture or point toward something interesting to show it to another person.

“If you took a typical 4-year-old to the zoo, for example, they’d point to show you all the different animals,” Loftin says. “Most kids with autism aren’t trying to direct others’ attention in that way.”

Lack of sharing

Kids with autism also might not show parents a plaything they think is interesting.

“This is another thing that typically developing kids do all day,” says Loftin. “If they’re playing with something and think it’s interesting, they’ll show it to other people to share it with them.

For instance, a young child who does not have autism may offer an adult a bite of his or her snack or hand them a toy to use.

Echoed phrases

Children with autism who do speak may parrot what you say, often with the same tone, which is called echolalia. For instance, Loftin says, “I might ask a child, ‘Do you want a drink?’ And if the child did want one, instead of saying, ‘I want a drink,’ he would say, ‘Do you want a drink?’”

Another common example is a child who might repeat a line they like from a movie or book over and over again. The phrase will often be out of context, like a script that is stuck in a child’s head.

Subtle troubles with social language

Some kids with autism don’t have problems with basic language skills. But they struggle with communication in other ways.

For instance, it might be difficult to interrupt them when they talk. Or they may want to talk only about certain topics or have a hard time carrying on a conversation. “They might answer direct questions well,” Loftin says. “But if you say, ‘Tell me about school today,’ creating a narrative that is more open-ended can be really challenging.”

This is an element of reciprocal communication, the back and forth that is fluid in most people. In conversation, people without autism will typically pause for another person, respond, stay on topic, and have a range of verbal and nonverbal reactions.

At the AARTS center, we often see families who have been struggling to find answers for a long time. It’s so rewarding to help them.

Parents: Trust your feelings

Having one or even two of these issues might not mean anything, Loftin notes. But it’s important for parents to talk to their pediatrician as soon as they do have concerns.

“Parents are essential to the diagnosis process,” she says. “It’s important that they follow their instincts because the earlier the intervention, the better the outcome.”

“It’s also okay to ask for additional opinions if you’re told not to worry and you’re worried,” Loftin notes. At Rush’s Autism Assessment, Research, Treatment and Services (AARTS) Center, parents receive a comprehensive evaluation of their child and multiple treatment options, and specialists at the center frequently provide second (and even third) opinions.

“We’re devoted to treating people with autism for their entire lifespan,” Loftin says. “When we’re making a plan to help a child, we’re thinking several steps ahead and picturing what this child is going to need to be a successful and independent adult.”


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